A Comparative Study of Risk Factors and Prognosis in Young and Elderly Patients with Acute ST-Segment Elevation Myocardial Infarction

Objective:To investigate the differences in risk factors and prognosis between young and elderly patients with acute ST-segment elevation myocardial infarction(STEMI)so as to provide a basis for the prevention of young patients with acute STEMI.Methods:Patients initially diagnosed with STEMI in the 920"Hospital of Joint Logistic Support Force of PLA from January 1,2018 to December 31,2022 were retrospectively enrolled in this study.A total of 235 STEMI patients aged≤45 years old and 532 STEMI patients aged≥65 years old were screened.The baseline characteristics,laboratory indicators,clinical characteristics,coronary angiography,SYNTAX score and major adverse cardiovascular events(MACE)during 1-year follow-up were analyzed and compared.Results:A total of 767 STEMI patients were enrolled,including 235 in the young group and 532 in the elderly group.Among the STEM patients in the young group,224 cases were male,and smoking and drinking were common.Compared with the elderly group,the young group had shorter hospital stays and more family history of ischemic heart disease(IHD).The level of low-density lipoprotein in the young group was higher than that in the old group,while the level of high-density lipoprotein in the young group was lower than that in the old group.The level of high uric acid and homocysteine in the young group was significantly higher than that in the old group.The main cause of STEMI in the young group was fatigue,and the most common symptom was angina pectoris.Coronary angiography showed that single vessel disease was more common in the young group than in the elderly group,and the lesion in the young group was the left anterior descending artery.The SYNTAX score was significantly lower in the young group than in the elderly group according to the anatomical characteristics of coronary artery disease.In the forest plot,diabetes mellitus and a family history of IHD showed a trend of major adverse cardiovascular events(MACE)in both groups.Conclusion:Males,smokers,alcohol drinkers and family history of ischemic heart disease are more common in young patients.Common risk factors include fatigue,hyperuricemia,hyperlipidemia and so on.In addition,age itself is an independent risk factor.Management of diabetes,hyperuricemia,and homocysteine levels is essential to reduce the incidence of cardiovascular events in young patients.By controlling these factors,the incidence of young patients with acute STEMI can be effectively prevented and the corresponding prevention and treatment basis can be provided.

Oxidative Stress During Antituberculous Therapy in Young and Elderly Patients

Using allantoin (ATN ) as a marker for reactive oxygen species (ROS), oxidative stress during antituberculous (anti-TB) therapy was compared in 10 young and 9 elderly patients.Before treatment, ATN plasma concentrations in patients were similar to that of volunteers. Administration of a combination of isoniazid (INH ), rifampicin (RIF) and pyrazinamid e (PZA) increased plasma ATN in both groups of patients. ATN concentrations (M± SE) at six hours were higher (P <0.05 ) in elderly than in young patients on day one,8.22 ± 1.50 vs 1.89 ± 0.98 μg/mL); day 30, (5.85 ± 0.82 vs 0.87 ± 0.57 μg/mL; and day 90, (4.84 ± 1.24 vs 0.52 ± 0.50μg/mL). Because total amount of ATN excreted was similar in both groups on the three occasions, more ATN was formed in elderly than young patients. In conclusion, there was more oxidative stress in elderly than young patients. It is thereby suggested that Anti-TB drugs induce formation of ROS and elderly patients are at a greater risk of toxicity probably because of poor antioxidant mechanisms

A Risk-Adjusted Retrospective Data Analysis between Younger and Elderly Patients with Acute Coronary Syndromes—Long-Term Prognosis

Purpose: To compare the demographic data and outcomes of younger versus elderly patients with acute coronary syndromes. Methods: This was a retrospective data bank analysis study with 966 patients (268 in the younger group (less than 55 years) and 698 in the elderly group (more than 55 years)). Data were obtained about clinical characteristics, angiography, and medication used at hospital and coronary definitive treatment. The primary endpoint was all cause of in-hospital death and combined events. Comparison between groups was made by Anova and Q-square. Multivariative analysis was determined by logistic regression and was considered significative when p < 0.05. Long-term mortality and combined events were studied using Kaplan- Meyer curves with median follow-up of 11.21 months. Results: The median age in the younger group was 48 years versus 69 years in the elderly group. In the younger group 26% was ST-myocardial infarction versus 18% in the elderly group. About 7% of younger patients were submitted to coronary bypass surgery and 42% to percutaneous coronary angioplasty versus 12% and 25% in elderly group, respectively. Significant difference was observed between the younger versus elderly groups in deaths (1.5% × 7.5%, p = 0.004), combined events (14.9% × 26.3%, p = 0.02) and killip III/IV (3.7% × 8.3%, p = 0.04). Long-term mortality was 3.7% × 10.2%, p = 0.01). Conclusions: In patients with acute coronary syndromes age was an important predictor factor of mortality and complications. Significative differences in outcomes were observed between the two groups in-hospital and long-term follow-up.

Age and Gender-Related Differences in Physical Functions of the Elderly Following One-Year Regular Exercise Therapy

Reports on physical functions during maintenance period of the elderly with cardiac and other serious diseases are limited. This study aims to clarify age and gender-related differences in their physical functions. Participants included 167 elderly individuals (males, 78;mean age, 76.5 years;SD = 6.0 years;females, 89;mean age, 75.5 years;SD = 4.5 years) who participated in a 1-year regular exercise therapy twice a week. The following eight physical function tests were selected: grip strength, 10-m obstacle walking time, one-legged balance with eyes open, sit-ups, sitting trunk flexion, 6-min walk, stepping by sitting position, and a timed up & go (TUG). Two-way analysis of variance was used to examine mean differences by gender and age: young elderly group (aged 65 - 74 years) and old elderly group (aged ≥ 75 years). In the grip strength, sit-ups, 6-min walk, 10-m obstacle walking time, stepping by sitting position, and sitting trunk flexion tests, males were superior in the former four tests, and females were superior in the latter two tests. The young elderly group was superior in all tests except for sit-ups compared with the old elderly group. The balance during one-legged with eyes open test was superior in males compared with females in the young elderly group, but decreased in males in the old elderly group. In conclusion, physical functions of the elderly during maintenance period are different between genders. Muscle strength, muscle endurance, whole-body endurance, and walking ability are superior in males, whereas flexibility and agility are superior in females. The old elderly group was inferior in all the elements of physical function except muscle endurance.

How Resilient Is the Family? An Empirical Study of Family Care for the Young and the Elderly

This study explores the strategies Chinese families employ to navigate substantial caregiving challenges in the context of demographic changes characterized by low birth rates and an aging populace, alongside a dearth of public and commercial caring resources. It delves into familial intergenerational cooperation, utilizing various resources such as connections, norms, and emotions to develop resilience that withstands external pressures. The research acknowledges the positive role of family resilience in safeguarding vulnerable members and maintaining social stability. However, it also highlights the fact that family resilience has its limits and does not have unlimited sustainability. Sustainable family resilience can be bolstered by redefining the distribution of duties and resources among the government, the community, and families for the care of the young and the elderly. This involves creating a multifaceted welfare system anchored by government backing that places families at its center and by improving the commercial provision of care services. This facilitates the positive self-generation and reproduction of caring resources within the familial framework.

Comparison of Inspection Data by Difference in Odour Inspection Kit (Including Results of Young and Old Age)

The present study examined the relationship between olfactory function for ten years. A personal function test was calculated from the Nagoya Women’s University study database, and the odor stick identification test and open essence identification test were administered to healthy young and elderly people. The participants were community dwellers who voluntarily participated in the Nagoya Women’s University Study and had managed everyday life by themselves. We combined data of 2018 and checked two kinds of the olfactometry result. These data were made from a consultation result list which was handed to a testee by hand. The test age was in his/her 80s from 40s and in his/her 20s from 10s. The data were compared according to the generation (young age is 20.1 ± 0.7 years old and old age is 74.5 ± 10.0 years old). We conducted two kinds of olfaction tests. The Odour Stick Identification Test (OSIT-J) was used to assess odour perception. This test possesses high reliability and validity. The OSIT-J includes 12 different odorants to be identified. The Odour Essence Identification Test was used to assess odour perception, too. It also includes 12 different odorants to be identified. We compared the answer of generation and compared the results of the two olfactory tests. As a result, there were no statistically significant differences in the total number of correct answers in young people and old people in the two olfactory test results. In addition, we compare young people and old people who increased the number of correct answer in the two kinds of olfactory examination, the same person, and those who decreased, but there was no statistically significant difference. However, there were statistically significant differences between India ink and perfume and Household (domestic) gas compared with young people and old people with two kinds of olfactory test results. From the results of this study, it was found that the results of two kinds of olfactory test can be used together as a research result for the result of correct answer rate number. However, it became clear that careful handing is necessary for individual smell.

低龄老年人参与积分制治理意愿的影响因素研究——以晋江市为研究区域

在全球老龄化现象呈递增式上升的背景下,中国未富先老的国情和乡村振兴的时代要求决定了老年人参与积分制治理具有重要作用。为了探究影响低龄老年人参与积分制意愿的影响因素以及效应,以晋江市H村实施“乡村治理积分制”为研究背景,从农村社区治理责任感知、面子观念和积分制政策感知3个维度来探究决定低龄老年人参与积分制意愿的因素。结果证明:“农村社区治理责任感知”不仅对“参与意愿”有直接效应,还可以通过间接影响“积分制政策感知”对低龄老年人参与乡村治理的积极性起推动作用。据此,提出完善政策公开公示机制、深入宣传政策细则以及构建村务民主协商制度等措施,以此来激励低龄老年人参与积分制的意愿。

青年与中老年2型糖尿病并发急性胰腺炎患者临床特点分析

目的探讨青年和中老年2型糖尿病并发急性胰腺炎患者的临床特点,为临床防治提供参考。方法选取2015年1月—2021年1月于北京积水潭医院急诊科确诊为2型糖尿病(T2DM)并发急性胰腺炎(AP)患者的病例资料,根据年龄分为青年组(<40岁,65例)和中老年组(≥40岁,71例)。分析比较两组患者的基本资料、入院当日的症状、体征及实验室检查指标、在院期间治疗过程、急性生理学与慢性健康状况评估系统Ⅱ(APACHEⅡ)评分等。分析影响青年和中老年2型糖尿病并发急性胰腺炎患者的独立危险因素。结果青年组T2DM患者并发AP的病因以高脂血症为主,中老年组病因以胆道疾病为主。青年组较中老年组患者的体质量指数(BMI)更高[kg/m^(2),28.0(24.4,30.9)vs 24.4(22.3,26.1),P<0.001],心率更快[次/min,101(86.0,110)vs 85.1(74.0,94.5),P<0.001],胰岛素治疗率更高[30(46.2%)vs 7(9.9%),P<0.001]。青年组患者的血糖、糖化血红蛋白、血红蛋白、血细胞比容、白细胞、血小板、淋巴细胞、中性粒细胞、尿酸、甘油三酯、胆固醇、胆碱酯酶、血钾水平均显著高于中老年组,差异均具有统计学意义(均P<0.05)。中老年组患者的谷丙转氨酶、总胆红素、谷草转氨酶、直接胆红素、血尿淀粉酶、碱性磷酸酶、尿素、谷氨酰转肽酶、血钠、血氯、D-二聚体水平均显著高于青年组,差异均有统计学意义(P<0.05)。青年组并发糖尿病酮症酸中毒(DKA)者更多(35.4%vs 5.6 P<0.001)。中老年组APACHEⅡ高于青年组[3.17分(0,4.00)vs 6.06分(3.00,8.00),P<0.001]及简化急性生理学评分Ⅱ(SAPSⅡ)评分高于青年组[6.49分(0,9.00)vs 14.5分(7.00,18.0),P<0.001]。根据危险因素分析结果绘制受试者工作特征曲线(ROC),计算各危险因素临界值。血糖、甘油三酯、尿酸、尿素曲线下面积分别为0.862(95%CI:0.798~0.927)、0.813(95%CI:0.739~0.886)、0.798(95%CI:0.720~0.876)、0.364(95%CI:0.270~0.458)。临界值分别为血糖13.95 mmol/L、甘油三酯3.20 mmol/L、尿酸465.00 mmol/L、尿素23.95 mmol/L。结论青年与中老年T2DM并发AP患者在病因及临床表现、实验室检查、住院天数等均有其特点。青年T2DM患者多并发脂源性AP,中老年T2DM多并发胆源性AP。甘油三酯、血糖和尿酸是青年人T2DM并发AP的独立危险因素,尿素是中老年人T2DM并发AP的独立危险因素。

谁是学生?——柏拉图《法义》解析

《法义》是柏拉图最为重要的教育著作之一,它涉及“谁是学生”的问题。在柏拉图看来,作为立法者的两位多里斯老人,是在场的学生;年轻人虽然被排斥在现场的对话之外,是缺席的,但他们同样也是学生。两位多里斯老人与作为教师的雅典人的关系并不密切,但作为学生,他们的天性是卓越的,可教的。年轻人之所以不在场,根本上是为了对老年人教育的顺利进行,因为年轻人的性情与老年人的性情存在差异,他们同时在场会影响良好教育效果的达成。柏拉图将学生进行分类,是出于次好城邦建构的需要,显现了柏拉图卓越的古典教育智慧。对于现代教育来说,《法义》对学习者的规定具有真理性,人们应该意识到学习者的差异并发挥教育者的实践智慧。

纯音听阈正常老年人畸变产物耳声发射特征

目的探讨纯音听阈正常老年人畸变产物耳声发射(DPOAE)特征。方法对纯音听阈正常的青年对照组39例和老年组30例分别行DPOAE检测,比较两组500～8 000Hz各频率DPOAE的检出率和幅值差异。结果老年组DPOAE检出率在3kHz及以下频率与青年组无明显差异(P>0.05),在4、6、8kHz处均明显低于青年组(P<0.05);老年组DPOAE检出率随频率增加而降低,0.5～3kHz DPOAE检出率高于4～8kHz,其中8kHz检出率最低,其次是6kHz和4kHz;老年组与青年组DPOAE幅值的频率特点基本一致,在中低频率幅值较高,在4kHz及以上频率明显降低;老年组各频率DPOAE幅值均低于青年组(P<0.05),差值平均约5.4dB,6、8kHz差值更大,分别为6.75及9dB。结论纯音听阈正常的老年人在4kHz及以上频率DPOAE幅值明显下降,说明该频率段外毛细胞功能减弱,且该现象青年时已开始显现,非老年人特有。

年轻乳腺癌患者和中老年乳腺癌患者疾病特征的对照研究

目的 分析年轻乳腺癌患者和中老年乳腺癌患者在病理分类、淋巴结转移率、以及相关因子中存在的差异。方法 常规病理检验以及应用免疫组化SP法分别测定年轻乳腺癌患者和中老年乳腺癌患者的ER、PR、CD4 4v6、CerbB - 2。结果 年轻乳腺癌患者浸润性非特异性乳腺癌的百分比为70 .7% ,特异性乳腺癌的百分比为 2 9.4 % ;中老年乳腺癌患者的浸润性非特异性乳腺癌的百分比为91.3% ,浸润性非特异性乳腺癌的百分比为 5 .6 % ,经卡方检验 ,P <0 .0 5。两组淋巴结转移率分别为70 .1%和 4 4 .4 % ,P<0 .0 5。两组ER阳性伴淋巴结转移的比例经卡方检验 ,P<0 .0 5。结论 年轻乳腺癌患者和中老年乳腺癌患者在病理分类、淋巴结转移率、ER阳性率对淋巴结转移的影响上有显著性差异。

特殊年龄段肝癌的临床病理特点(附100例报告)

目的 分析特殊年龄段肝癌的临床和病理特点。探讨不同的诊治途径和综合对策。方法 我科 1995年 8月至 1999年 8月收治的原发性肝癌 480例 ,选年龄≤ 40岁和年龄≥ 60岁两组 (即青年组和老年组 ) ,对比分析两年龄段患者HBsAg阳性率、ALT异常 (高于正常 4倍 )、AFP阳性 ( >40 0 μg/ml)、肝癌类型、门静脉癌栓、手术切除率及存活率的差异。结果 2年龄段有显著性差异结果 (P <0 .0 5 )分别是 :HBsAg阳性率 ( 90 % ,5 5 % )、ALT异常 ( 88.89% ,5 0 % )、AFP阳性 ( 70 % ,37.5 0 % )、弥漫性肝癌 ( 2 3.33% ,7.5 0 % )、门静脉癌栓 ( 2 0 % ,7.5 0 % )。而存活率 :青年组术后存活超过3年 3例 ,老年组有 6例超过 3年。结论 青年人肝癌恶性程度高于老年人 ;恶性程度与肝炎活动、肿瘤侵润生长有关 ;对高危青年 ,应定期检查AFP和B超以获得早期发现和及时治疗 ;老年肝癌手术切除仍可取得较好疗效。

对我国教练员与运动员关系的理论思考

教练员与运动员之间是一种特殊的人际关系。这种关系既是社会公民间的平等关系。又是师生间教育与被教育的关系,也是长幼间相互关心体贴的关系。这种关系的三个层面本身在调节教练员与运动员关系时所处的地位不同。要处理好教练员与运动员之间的关系,了解掌握其关系的特点与规律有重要意义,把握不同时期、不同阶段关系变化的规律。

青年与中老年急性脑梗死分型及危险因素对比分析

目的探讨青年与中老年急性脑梗死病因分型、危险因素等方面的异同。方法回顾性分析2015年6月～2018年6月在我院住院的青年脑梗死患者50例作为青年脑梗死组,并随机抽取同期住院的中老年脑梗死患者63例作为中老年脑梗死组,对其TOAST分型、危险因素进行对比分析。结果青年脑梗死与中老年脑梗死组最常见的病因分型均为LAA,青年组其次为SAO、OD,两组比较差异有统计学意义(P<0.05);两组最常见的危险因素均是高血压,而吸烟、酗酒常见于青年脑梗死组,差异有统计学意义(P<0.05),青年脑梗死组高尿酸血症患者多于中老年脑梗死组,差异有统计学意义(P<0.05),提示高尿酸血症是青年脑梗死的独立危险因素。结论 TOAST病因分型均以LAA型为主,其次SAO;危险因素方面,两组均以高血压最常见,青年脑梗死组吸烟、酗酒人数多,应加强青年人的宣传教育,戒烟、戒酒,以期减少脑梗死的发生率及延缓发病年龄。高尿酸血症是青年脑梗死的独立危险因素,饮食上应注意减少高嘌呤食物摄入,防止尿酸升高,减少脑卒中发生。

金代尊老养老风尚述论

尊老养老是中国古代国家礼制的一项重要内容。女真人建立国家后,借鉴中原封建王朝的统治策略,一改北方民族"贵壮贱老"的旧俗,继承华夏历代尊老敬老的传统,制定、实施了多种优待和救助老人的政策和措施,如物质救助、赏赐钱物、赐官加爵、宴请优待、刑律优免等。由于统治者的大力倡导,金朝形成了尊老敬老的社会风尚。

青年及老年原发性肝癌的临床分析

目的 :探讨青年及老年人原发性肝癌的临床特点。方法 :对 95例年龄≤ 3 9岁的青年肝癌和 112例年龄≥ 60岁的老年肝癌患者进行临床分析。结果 :(1)青年组HBV感染率为 92 .63 % ,其中HBsAg(+ )为 84.2 1% ,明显高于老年组的 62 .5 0 % ,P <0 .0 1。 (2 )青年组合并肝硬化者达 72 .63 % ,高于老年组的 5 4.46% ,P <0 .0 1。 (3 )青年组肝区疼痛症状明显高于老年组 ,前者以弥散型和巨块型多见 ,而后者则以单个局限为主。 (4)青年组甲胎蛋白 [AFP(+ ) ]为 67.3 7% ,老年组为 46.43 % ,P <0 .0 5。 (5 )老年组AKP、γ GT明显高于青年组 ,心脑血管合并症亦多于青年组 ,P <0 .0 1。结论 :青年肝硬化患者是原发性肝癌最重要的高危因素 ,应对这些患者长期追踪观察以早期发现和诊断。老年肝病患者AFP阳性率低 ,当其出现AKP、γ GT值升高时 ,应高度警惕肝癌。

青年与老年肾癌的病理特点分析比较

目的:对比分析青年与老年肾癌患者的病理特点的异同。方法和材料:将我院2005-2009年期间收治的84例符合条件的肾癌病例,按照年龄分为小于等于40岁的青年组(36例)和大于40岁的中老年组(48例),对其病理类型做对比分析。结果:两组病例病理类型均以透明细胞癌为主,所占比例分别是72.22%(26/36)和85.42%(41/48),在青年组发现5例Xp11.2易位/TFE3基因融合相关性肾癌,为老年组所没有的类型。结论:两组的病理类型均以透明细胞癌为主,但在青年组有Xp11.2易位/TFE3基因融合相关性肾癌,这一新的肾癌类型为今后青少年肾癌的研究提供了方向。

青年与老年肾癌的临床特点分析比较

目的:对比分析青年与老年肾癌患者的临床表现、诊断及TNM分期的异同。方法和材料:将我院2005-2009年期间收治的84例符合条件的肾癌病例,按照年龄分为小于等于40岁的青年组(36例)和大于40岁的中老年组(48例),对其临床表现、实验室检查及影像学检查、临床TNM分期做对比分析。结果:两组患者偶发癌的比例较高,青年组52.78%(19/36),老年组62.50%(30/48)。有症状型肾癌,青年组比例(47.22%)高于中老年组(37.50%),均以腰痛和血尿为主,部分患者有腰痛和血尿两种症状,两组间差异无显著性。肾癌的肾外表现青年组以血红细胞的改变为主(38.89%,14/36),中老年组以血压的改变为主(27.08%,13/48),两组患者超声检查的准确率分别为94.44%(34/36)和93.75%(45/48),CT的诊断准确率分别是96.97%(32/33)和97.50%(39/40)。两组患者临床分期青年组T1期66.67%(24/36),T2期8.33%(3/36),T3期11.11%(4/36),T4期13.89%(5/36),有淋巴结转移的5.56%(2/36,均为N1),有远处转移的M1有2.78%(1/36);中老年组T1期62.50%(30/48),T2期10.42%(5/48),T3期12.50%(6/48),T4期14.58%(7/48),有淋巴结转移的N1有4.17%(2/48),N2有2.08%(1/48),远处转移的M1有2.08%(1/48)。所有病例均行根治性肾切除术或保留肾单位的肾部分切除术,术后部分患者接受了免疫治疗。结论:肾癌偶发癌的比例明显较文献报道提高,有增加的趋势。在青年组偶发癌的比例、临床表现、TNM分期及主要治疗方法与老年组一致,之间差别无显著性。

关于有序树存贮与恢复算法的研究

提出了一种适用于有序树的存贮与恢复的算法。具有简洁明了、实现效率高、占用存储空间小等特点。

青年食管癌与中老年食管癌外科诊治的比较研究

分析青年与中老年食管癌患者的临床特征及外科治疗效果。回顾性分析49例青年和98例中老年食管癌患者的临床资料。结果:青年食管癌占同期食管癌的6.55%,两组患者在性别比例、肿瘤病变部位、病理类型、分化程度等差异无统计学意义(P>0.05);在术后病理分期、根治性切除率、术后并发症发生率上差异均有统计学意义(P<0.05);青年组与中老年组的手术死亡率分别为0.0%和2.0%,两组生存率差异无统计学意义(P>0.05)。结果表明,青年人食管癌肿瘤病期偏晚,手术切除率更低,术后并发症发生率及手术死亡率优于中老年组,两者在生存预后差别无统计学意义。